HB2591 102ND GENERAL ASSEMBLY

LRB102 14297 KTG 19649 b

102ND GENERAL ASSEMBLY
State of Illinois
2021 and 2022
HB2591

Introduced 2/19/2021, by Rep. Deb Conroy

SYNOPSIS AS INTRODUCED:

305 ILCS 5/5-5.25

Amends the Medical Assistance Article of the Illinois Public Aid Code. Requires the Department of Healthcare and Family Services to reimburse physicians, community mental health centers, and substance abuse centers that provide primary care and behavioral health services to medical assistance recipients via telehealth, including medical evaluations for individuals residing in facilities licensed under the ID/DD Community Care Act and in community-integrated living arrangements. Requires the Department to establish, by rule, a method to reimburse providers for medical and behavioral health services (rather than mental health services) provided by telehealth. Requires the Department to reimburse any community mental health center, facility licensed under the ID/DD Community Care Act, and community-integrated living arrangement that acts as the location of the patient at the time a telehealth service is rendered.

FISCAL NOTE ACT MAY APPLY

A BILL FOR

AN ACT concerning public aid.

Be it enacted by the People of the State of Illinois, represented in the General Assembly:

Section 5. The Illinois Public Aid Code is amended by changing Section 5-5.25 as follows:

(305 ILCS 5/5-5.25)

Sec. 5-5.25. Access to behavioral health and medical services.

(a) The General Assembly finds that providing access to behavioral health and medical services in a timely manner and in the most appropriate setting will improve the quality of life for persons suffering from illness, will reduce the spread of infectious diseases to the general public, and will contain health care costs by avoiding the need for unnecessary visits to the emergency room and more costly inpatient hospitalization.

(b) The Department of Healthcare and Family Services shall reimburse physicians, psychiatrists, community mental health centers, substance abuse centers, federally qualified health centers as defined in Section 1905(l)(2)(B) of the federal Social Security Act, clinical psychologists, clinical social workers, advanced practice registered nurses certified in psychiatric and mental health nursing, and mental health professionals and clinicians authorized by Illinois law to provide primary care and behavioral health services to recipients via telehealth, including medical evaluations for individuals residing in facilities licensed under the ID/DD Community Care Act and in community-integrated living arrangements as defined in the Community-Integrated Living Arrangements Licensure and Certification Act. The Department, by rule, shall establish: (i) criteria for such services to be reimbursed, including appropriate facilities and equipment to be used at both sites and requirements for a physician or other licensed health care professional to be present at the site where the patient is located; however, the Department shall not require that a physician or other licensed health care professional be physically present in the same room as the patient for the entire time during which the patient is receiving telehealth services; and (ii) a method to reimburse providers for medical and behavioral health services mental health services provided by telehealth.

(c) The Department shall reimburse any Medicaid certified eligible facility or provider organization that acts as the location of the patient at the time a telehealth service is rendered, including community mental health centers certified by the Department of Human Services' Division of Mental Health, substance abuse centers licensed by the Department of Human Services' Division of Alcoholism and Substance Abuse, facilities licensed under the ID/DD Community Care Act, and community-integrated living arrangements as defined in the Community-Integrated Living Arrangements Licensure and Certification Act.

(d) On and after July 1, 2012, the Department shall reduce any rate of reimbursement for services or other payments or alter any methodologies authorized by this Code to reduce any rate of reimbursement for services or other payments in accordance with Section 5-5e.

(Source: P.A. 100-385, eff. 1-1-18; 100-790, eff. 8-10-18; 100-1019, eff. 1-1-19; 101-81, eff. 7-12-19.)